DR. JACLYN M GRENTZER (NPI# 1215240338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215240338 |
| Entity Type | Individual |
| Full Name | DR. JACLYN M GRENTZER |
| Credential | MD |
| Practice Address |
4901 Forest Park Ave Ste 420 Saint Louis MO 63108-1402 |
| Mailing Address |
660 S Euclid Ave C B 8064 Saint Louis MO 63110-1010 |
| Practice Telephone | 3143624211 |
| Practice Fax Number | 3142226245 |
| Mailing Telephone | 3143624211 |
| Mailing Fax Number | 3142226245 |
| Enumeration Date | 2010-07-18 |
| Last Update Date | 2015-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 2014013914 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
4901 FOREST PARK AVE STE 420 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-1402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455964 | Edmond S Weisbart | Internal Medicine | 4901 Forest Park Ave, Wohl Clinic Ste 241, Saint Louis, MO 63108-1402 | 2005-05-27 |
| 1912523788 | Julie Nicole Milton | Student in an Organized Health Care Education/Training Program | 4901 Forest Park Ave, Saint Louis, MO 63108-1495 | 2020-06-17 |
| 1881153815 | Tiffany Rochelle Anzalone | Nurse Practitioner | 4901 Forest Park Ave, Ste 420, Saint Louis, MO 63108-1495 | 2019-03-19 |
| 1366962201 | Scott Andrew Skillington | Otolaryngology | 4901 Forest Park Ave, Saint Louis, MO 63108-1402 | 2017-06-21 |
| 1366962417 | Amaad Bashir Rana | Internal Medicine | 4901 Forest Park Ave, Ste 241, Saint Louis, MO 63108-1495 | 2017-06-20 |
| 1285087601 | Aisling Elizabeth Doyle | Internal Medicine | 4901 Forest Park Ave, Ste 241, Ms 90-75-555, Saint Louis, MO 63108-1495 | 2016-07-20 |
| 1255784930 | Brandt Thomas Lydon | Internal Medicine | 4901 Forest Park Ave, Ste 241, Ms 90-75-555, Saint Louis, MO 63108-1495 | 2016-07-19 |
| 1992155949 | Joseph Cataquiz Rimando | Internal Medicine | 4901 Forest Park Ave, Ste 241, Ms 90-75-555, Saint Louis, MO 63108-1495 | 2016-06-20 |
| 1104276336 | Shakthi Tapasya Bhaskar | General Practice | 4901 Forest Park Ave, Ste 241, Ms 90-75-555, Saint Louis, MO 63108-1495 | 2016-06-19 |
| 1508216805 | Adam Nicholas Lick | General Practice | 4901 Forest Park Ave, Ste 241, Ms 90-75-555, Saint Louis, MO 63108-1495 | 2016-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568984367 | Gsh Lab LLC | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 1017b, Saint Louis, MO 63141-8264 | 2017-07-13 |
| 1851825715 | Sydni Fazenbaker Crowell | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2009b, Saint Louis, MO 63141 | 2017-04-18 |
| 1962865170 | Zachary Keller | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 499a, Saint Louis, MO 63141-8260 | 2016-04-04 |
| 1174985154 | Leah Hong | Obstetrics & Gynecology | 6420 Clayton Rd Ste 2800, Saint Louis, MO 63117-1811 | 2016-03-28 |
| 1972997088 | Jennifer E Powel | Obstetrics & Gynecology | 6420 Clayton Rd Ste 230-a, Saint Louis, MO 63117-1811 | 2015-03-26 |
| 1386068864 | Wcc 2, LLC | Obstetrics & Gynecology | 3023 N Ballas Rd Bldg D, Suite 120d, Saint Louis, MO 63131-2330 | 2014-02-05 |
| 1881987410 | Herman Taute | Obstetrics & Gynecology | 12040 Heatherdane Dr, Saint Louis, MO 63131-3119 | 2011-05-16 |
| 1174828198 | Frank Eugene Hunleth | Obstetrics & Gynecology | 5331 Donovan Ave, Saint Louis, MO 63109-2635 | 2011-01-22 |
| 1972804631 | Anastasios K Dagartzikas | Obstetrics & Gynecology | 12902 Tundra Ct, Saint Louis, MO 63131-1319 | 2010-11-11 |
| 1811227390 | Laurel D Fendrich | Obstetrics & Gynecology | 10010 Kennerly Rd Fl 4, Saint Louis, MO 63128 | 2010-01-06 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.